Question
My CD4 count has gone down quickly should I be worried?
7 March 2011. Related: All topics, CD4 and viral load.
I was diagnosed in November and both my CD4 and my viral load were about 1100 at the time.
I had another appointment today, and currently, my CD4 is 650, and my viral load stayed the same.
Why such a large drop in such a small period of time? I was under the impression that the CD4 count decreases at a rate of about 100 a year, so I definitely was not expecting this :(
Answer
Thank you for your question.
I am sorry to hear you are disappointed with your CD4 count. I have to say though, a CD4 count of 650 is very good!
CD4 fluctuations are common. CD4 count results can depend on many things such as the time of day a test is done, exercise, menstrual cycle, stress, how much sleep you had, other underlying infections, vaccinations and lab mistakes. If you are worried and fluctuations are occurring regularly it may be worth talking to your doctor about having multiple tests done at one time to ensure it is not a lab error.
Only a small proportion of CD4 cells are found in the blood, the rest are found in either your lymph nodes or tissues. The CD4 cells travel between the blood, the lymph nodes and tissues. This movement of CD4 cells in and out of the blood could also cause fluctuations in your test results. Please try not to worry about this as stress can cause a decrease in the CD4 count and your CD4 count really is good!
Hi Lisa,
If you’re feeling like this, you need to talk to a doctor.
This is scary started treatment at CD4 of 458 and viral load 350 was healthy about 4 months on treatment but I now feel very sick..just not well at all, losing weight skin rash concurrent throat infections am taking medication as directed and never missed a dose what could be the cause of this?
Hi Shona,
Are you on medication? Do you adhere to your meds? Do you know what your viral load is? If you’re on meds and your viral loads been going down and hasn’t risen as your CD4 has dropped this would suggest that you’ve had a CD4 blip. Please see here:
http://i-base.info/qa/424
am soo concerned and worried of how my CD4 has dropped from 650 to 350. what do I need to do about this kindly help. am I on the safe side or not.
Hi Gertrude,
It is possible to see fluctuations in your CD4. However, given this level of drop you should arrange to have your CD4 measured again. Other than your CD4, do you know what your viral load is?
Hi doc, i am really worried is is possible to have CD4 drop from 414 to 55 within a period of 3 months especially when diet and medications are consistent?
Hi Zaw, results can chance because of lots of reasons, but if your CD4 count is under 350 it is definitely a good idea to start treatment. Your doctor is giving oyu good information.
Dear Sir/Madam,
My last blood test was in 16 January 2016 and I was HIV negative that time. I stopped testing for blood after that. Last week in Sepetem 2016 ,I checked again n I found out that I have HIV POsitive and I have to make further test about CD4 count and the report said my CD4 is 227.And the consultant doctor told me to start treatment as soon as possible.I am looking just normal like I was before.I cannot believe that my CD4 Become so Low in just about 9 years.I cannot believe myself to the report.I thought I would have had CD4 about 500.But it turned out to be 227 in the report.Could you please explain what is the reason why my CD4 drop so quickly not in just one year full?Shall I start treatment right away?Thank you very much and waiting for your reply.
Hi Victoria
These changes are all too small for them to be considered medically important.
Your viral load is still very low and a change 3 times higher or lower is considered within the range of variability of the test.
There are different guidelines for when to start treatment in different countries. Almost all guidelines recommend starting before CD4 counts drop below 350 and a few before falling below 500.
Some countries include the option to start at any CD4 count, but there is little evidence from research studies to show that this will have an impact on your health, if you are otherwise healthy.
Several studies are looking at whether starting treatment earlier in balance by the risks of earlier treatment, including the START study.
http://i-base.info/home/start-study/
So long as your results are generally this good, try not to worry when they fluctuate as this is normal.
Diet, exercise and stopping smoking (both cigarette and marujuana smoke damages your lungs) are all good changes to help your long-term health.
I was back at the doctor yesterday, and my CD4 has risen a little to 685, and my VL has fallen to 650. My CD4% has fallen a little to 22% though. I am still unmedicated, and I wanted to know at what point must I start medication? My doctor said my numbers are still good enough for meds not to be totally necessary, but i’m unsure at what point they will be.
Also, I recently started to watch what I eat/exercise (more than the nothing I was doing before at least), and I wondered if that paired with me recently stopping smoking marijuana is what caused my VL to decrease/CD4 to increase?